Many skin disorders can look alike and, as such, it takes a well trained eye to determine exactly what is taking place on the skin, and even then a second or third trained eye may be needed. I often run into cases where I encourage the patient to see another physician, especially in cases where the diagnosis seems somewhat hazy, or is something that I am not comfortable treating – skin cancer being one of them! In the past year alone, I have encouraged at least 4 different individuals to see western trained dermatologists as I was certain that they had something different than what they thought.
The first two patients had been told by previous practitioners, both western MD’s and alternative natural doctors, that they had psoriasis, which was clearly not the case. While psoriasis can be tricky to diagnose from time to time, it usually presents with a fairly identifiable pattern that both of these patients did not have.
For the past 20 years, the first individual had a sore on only one side of his chest, an obvious red flag that it may be something other than psoriasis, as psoriasis is usually symmetrical. To make matters worse, the sore was ulcerated and would ooze yellow fluid, which is also not characteristic of psoriasis. I suspected a condition called paget disease, which I knew could become cancerous. I encouraged this man to have a biopsy through a western specialist and sure enough he did have cancer. Luckily the cancer had not spread too deeply into the surrounding tissue, which is somewhat of a miracle considering the length of time he had it – 20 years!
The other individual had many random red and raised spots all over his body, which all had a yellowish scale. He told me that he was a sun lover for many years, a fact that helped confirm that he had a condition called actinic keratosis, or solar keratosis, which is a condition that arises from sun damage. Upon closer examination I noticed that many of them were bleeding and ulcerated, taking a long time to heal, which led me to think that these may be squamous cell carcinoma – a common evolution of the actinic keratosis. I encouraged this man to see a western dermatologist to confirm diagnosis and to offer treatment, as I believe one of the best ways to rid oneself of this type of cancer is surgical.
The third patient that I referred on for further examination was actually a group of 5 people – a new mother, her mother, her infant son, her father, and her husband. All of them had somehow developed a ‘mysterious’ and itchy rash 6 months previously, right around the birth of the infant. The general physician who saw them thought that the new mother may have had scabies, but changed his mind when she did not seem to respond to the medicines he prescribed to her. He declared that infants do not get scabies, so must have eczema, and prescribed a topical steroid. No diagnosis was given for the others. A referral was put in to see a western dermatologist which, due to our long back list in British Columbia, was in another 6 months time. Upon investigation I diagnosed scabies, in fact I thought it to be one of the worst cases I had ever seen, taking note that it was probably the infant that was actually passing it around when everyone would hold him. I encouraged this family to go straight to the hospital emergency and tell them what I found, for which they did that same day. The on-call emergency dermatologist agreed with me and was thus able to offer swift treatment, a much appreciated move as I could not imagine them living with this condition for another 6 months!
The last case, for which I encouraged a referral, did indeed have psoriasis, which responded very well to Chinese herbal medicines. The problem was that there was a solitary lesion on the patient’s neck that did not respond and upon close examination looked suspicious with tiny blood vessels growing in it (another red flag that could indicate basal cell carcinoma). To be safe I encouraged this patient to seek the advice of a western trained dermatologist, for which we are still waiting for feedback.
Misdiagnosing is common, but preventable. The main part is to become knowledgeable with what common skin disorders look like, so that when something appears differently than the norm we can ask for other opinions. The very first text book dedicated to dermatology in Chinese medicine, the Liu Juan Zi Gui Yi Fang (Liu Juan Zi’s Formulas Inherited by Ghosts, 479 to 502 AD), explicitly explains how some sores found on the body are associated with death, or are not treatable, and so again pointing out the importance a correct diagnosis!
Wishing you health,
Dr. Trevor Erikson
Copyright © 2019 Dr. Trevor Erikson